Kansas State University Center on Aging April 2006 PEAK Project Newsletter Future of Health Care An Interview with Bruce Yarwood, President of the American Health Care Association . . . . . " The one thing I do foresee in the future of LTC is change. . . Baby boomers look primarily for a few things when making long term care choices choice, quality and independence. We've seen market forces create assisted living; now we're seeing the fast emergence of home- and community-based care. Consumer demand is creating these marketplaces and the baby boomers are the most politically influential demographic we've ever seen that will continue to influence the long term care space." Provider, January 2006, pg 18-19 MOVIE REVIEW More Than Skin Deep Set against the backdrop of a nursing home beauty shop, this video examines issues of self-esteem and aging through the stories and insights of six nursing home residents. It takes an evocative look at the connections between living well, aging with dignity, and looking good. Award-winning filmmaker David Gaynes was inspired to make this film after a summer working as a transport volunteer at a nursing home. "I particularly enjoyed taking residents to and from the beauty shop," he recalls. "The change in self-esteem from the time I would drop a person off to the time I would pick the same person up was unmistakable. For many residents it was the highlight of their day." Life in a nursing home can be lonely and disorienting. The beauty shop and its rituals offer an example of the ways a good long- term care facility can help residents stay connected to their past lives, to their self-identity, and to each other. Leadership is based on inspiration, not domination; on cooperation, not intimidation. William Arthur Wood A sense of humor is part of the art of leadership, of getting along with people, of getting things done. Dwight D. Eisenhower The Journey Toward Culture Change Continues In our continuing effort to capture the essence of the PEAK winners' success in pursuing "nontraditional" models of care with progressive environments, we are featuring a few more homes that are leaders in this field. Medicalodge of Kinsley Medicalodge of Kinsley received the PEAK award in 2005 for its many achievements in the improvement of residents' and staff's quality of life. This home is resident -centered. Residents are in control of what and when they eat. They are encouraged to have meals in the main dining room to foster social time to interact with others. However, when residents prefer to eat in their rooms, staff deliver meals there. Staff try to bring variety to the dining experience, and each month department heads plan a noon meal with a special theme. The tables are decorated according to the theme, and meals are served by the department heads on that day. Residents can collect points for their part can be exchanged for items from the shopping cart or a lunch of resident's choice. This meal is special not only because it is chosen by the resident but also because it is carefully prepared and served by the activity director. The home offers a diverse activity program. Residents can join group activities or participate one- on- one with staff. Staff consider the different cognitive levels of residents and offer appropriate activities for each level. The residents determine what types of activity they participate in. Many activities outside of the home are offered to residents. They can choose to have a soda and snack in a local hangout or sign up for a trip to a bigger town. Many residents like to go shopping, visit the zoo, go on picnics, and attend parades. Special events are also planned for the residents'enjoyment. When the administration sponsored a motorcycle rally, residents not only had the opportunity to watch the bikers parade in town, but they could also see the bikes up close in the home's parking lot. A few of them took up the offer to go on a motorcycle ride. Another event many residents think fondly of is Spa Day. Volunteers offered residents a massage in a room that was filled with fresh flowers and soothing music. Women got their nails painted, and men got a shave and a splash of refreshing after-shave. Every participants' hair was styled by the end of the event. Staff empowerment is a strong attribute of the Kinsley Medicalodge. Frontline workers are involved in care plan development and implementation. All problems are discussed among team members. Team leaders work with their members to solve conflicts and enhance the services they provide. The management rewards employees for doing extra work with an appreciation note and a snack. Nobody's birthday and employment anniversary is forgotten. Employees choose a co-worker as an "Employee of the Month", and from these twelve employees an "Employee of the Year" is selected. The staff write a bi-monthly newsletter which is available to residents and employees, and is mailed to families, and distributed to communities. Some stories are published in the local paper. Medicalodge of Kinsley is the residents' home, and all rooms reflect this. One of the rooms was adapted to allow family members to be close to their loved one at the end of life. A recliner or daybed is available to accommodate family members wanting to spend more time with their loved one. The administration strives to have flowers throughout the entire home. An enclosed yard provides residents a place to walk where they can enjoy looking at the outdoor flowers. Some residents like to garden and this is where they can cultivate the hobby. The home has a chapel where residents can attend mass, which is offered two times per week, use it for meditation, or enjoy the quiet. Community is an important part of residents' lives. Elementary school children visit residents, play games with them, or spend time reading together. Older children play music, share their gymnastic talents, and sing. Adult volunteers are engaged in many projects like sewless-quilting. The home sponsors many local activities and clubs. No major holiday passes without the presence and/or participation of the community. For all these achievements and continuing efforts in increasing residents' and staff's quality of life, Medicalodge in Kinsley was awarded with the PEAK recognition in 2005. Create an environment that is fun and you create an environment that people want to be a part of. Rich DiGirolamo Medicalodge of Wichita Medicalodge of Wichita was built a few decades ago and not much can be done to redesign its looks. Knowing its structural limits makes it even more impressive that the administration has had a vision to make this place a home for residents. The facility was divided into seven neighborhoods, and the residents decided the name for each one. Having the residents grouped in their small communities has enhanced the resident-centered model. Each week the Resident Council meets with the administration to identify their preferences, express their opinions, and work on the best solutions for their problems. One of the biggest projects is a breakfast program. Residents choose what will be served for breakfast, and they can decide if they want to get up early or come at a later time since breakfast is served between 7 and 10:00 A.M. The idea is so well liked by residents that a salad bar is going to be introduced soon. A group of residents would rather have a salad than a regular entr‚e, and the salad bar will accommodate their needs. Each month residents vote on a special meal for the month. Most of them enjoy ethnic foods like Mexican or Chinese. The hydration cart circles the home two times a day offering residents a variety of healthy beverage choices. Residents enjoy summers even more due to monthly cookouts in their pretty courtyard. The administration's goal is to engage each resident. The activity program is offered seven days per week with the last activity available until 8:30 PM. For immobile residents aromatherapy is offered in their rooms. People with dementia and Alzheimer's receive regular activities to stimulate their senses and stay engaged through Twilight Group. Residents under the age of 55 formed their own group and identify activities they like to pursue. Women have created a Red Hat Society and proudly wear their red hats when they participate in indoor and outdoor activities. Residents and administration have been very creative in meeting residents' various interests and hobbies. Residents go shopping twice per month; they can participate in weekly bible studies or enjoy music therapy from a licensed professional. The Resident Council is a very effective voice for the residents, and its power is reflected in many theme groups and the richness of activities. Forming the neighborhoods not only enhances residents' quality of life, but it also helps staff be better care providers. By working consistently with the same residents aides know them better and they form close relationships with each other. Medicalodge of Wichita invests in their staff members by providing many training and education opportunities. Staff are offered promotions after they complete geriatric training. The clearly defined advancement path for staff creates a positive working environment which in turn directly reflects on residents' mood, demeanor and quality of life. Volunteers are part of the Medicalodge life. They help organize an annual garage sale in order to increase the home's activity budget. Many volunteers donate items for Bingo winners and provide transportation to church. Children from the Boys and Girls Club of Wichita spend many summer days with residents. They play Bingo, work on puzzles together and enjoy each other's company. Medicalodge of Wichita tries very hard to provide a good home to its residents. The administration asks the residents' family members for their feedback every three months in order to maintain and/or increase quality of life for its residents. This ongoing attempt for the betterment of the residents' lives and frontline workers' satisfaction has earned Medicalodge of Wichita PEAK recognition in 2005. I have never been especially impressed by the heroics of people who are convinced they are about to change the world. I am more awed by those who struggle to make one small difference after another. Ellen Goodman BOOK REVIEW Caring for People with Challenging Behaviors Essential Skills & Successful Strategies in Long-Term Care At some point, almost 80% of long-term care residents display moderate to severe behavior problems stemming from mental illness, dementia, difficult personalities, long-standing behavior patters or personal distress. Dealing with these behavior problems is often the most demanding part of a caregiver's job. This innovative book helps professional caregivers develop effective ways to prevent, reduce, or eliminate residents challenging behaviors and alleviate their own stress. Through numerous vignettes of readily recognizable resident types, staff will learn to identify what triggers and reinforces residents' challenging behavior. Recommended solutions for improving behavior include identifying the interpersonal "ABCs of Behavior" the antecedents, the behaviors, and the consequences and using practical communication techniques and evidence-based psychological approaches to encourage positive behavior. Stephen Weber Long, Health Professions Press, 2005.